title: Alcohol misuse and psychological resilience among U.S. Iraq and Afghanistan era veterans.
abstract: OBJECTIVE
  The present study sought to investigate the longitudinal effects of psychological resilience against alcohol misuse adjusting for socio-demographic factors, trauma-related variables, and self-reported history of alcohol abuse.
  
  
  METHODS
  Data were from the National Post-Deployment Adjustment Study (NPDAS) participants who completed both a baseline and one-year follow-up survey (N=1090). Survey questionnaires measured combat exposure, probable posttraumatic stress disorder (PTSD), psychological resilience, and alcohol misuse, all of which were measured at two discrete time periods (baseline and one-year follow-up). Baseline resilience and change in resilience (increased or decreased) were utilized as independent variables in separate models evaluating alcohol misuse at the one-year follow-up.
  
  
  RESULTS
  Multiple linear regression analyses controlled for age, gender, level of educational attainment, combat exposure, PTSD symptom severity, and self-reported alcohol abuse. Accounting for these covariates, findings revealed that lower baseline resilience, younger age, male gender, and self-reported alcohol abuse were related to alcohol misuse at the one-year follow-up. A separate regression analysis, adjusting for the same covariates, revealed a relationship between change in resilience (from baseline to the one-year follow-up) and alcohol misuse at the one-year follow-up. The regression model evaluating these variables in a subset of the sample in which all the participants had been deployed to Iraq and/or Afghanistan was consistent with findings involving the overall era sample. Finally, logistic regression analyses of the one-year follow-up data yielded similar results to the baseline and resilience change models.
  
  
  CONCLUSIONS
  These findings suggest that increased psychological resilience is inversely related to alcohol misuse and is protective against alcohol misuse over time. Additionally, it supports the conceptualization of resilience as a process which evolves over time. Moreover, our results underscore the importance of assessing resilience as part of alcohol use screening for preventing alcohol misuse in Iraq and Afghanistan era military veterans.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA. Electronic address: kimberly.green@duke.edu.
authors.forename: Kimberly T
authors.initials: KT
authors.lastname: Green
authors.forename: Jean C
authors.initials: JC
authors.lastname: Beckham
authors.forename: Nagy
authors.initials: N
authors.lastname: Youssef
authors.forename: Eric B
authors.initials: EB
authors.lastname: Elbogen
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D000367:Age Factors; D019973:Alcohol-Related Disorders / Q000453:epidemiology / Q000523:psychology*; D003130:Combat Disorders / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D005500:Follow-Up Studies; D040261:Harm Reduction; D006801:Humans; D054542:Iraq War, 2003-2011; D016014:Linear Models; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D055500:Resilience, Psychological; D057566:Self Report; D012737:Sex Factors; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data
keywords: Military veterans; Resilience; Substance misuse